血液病和恶性肿瘤患者输注不同贮存时间去除白细胞悬浮红细胞疗效分析

Effect of leukocyte-depleted suspended red blood cells storaged for different time on patients with hematologic diseases and malignant tumors

目的探讨不同贮存时间的去除白细胞悬浮红细胞(简称去白悬红)对血液病和恶性肿瘤患者的输注疗效,以评估血站目前的去白悬红的贮存质量。方法选择本中心供血的7家不同级别用血医院(三级甲等4所、二级甲等3所),收集各院2018年12月~2019年5月血液病和恶性肿瘤患者的输血病例(历)及其相关资料(指标),包括输血前的疾病诊断(种类)、人口学特征、单独输注去白悬红的日期、输注的去白悬红量[(1~2)U/袋,1 U=200 mL全血制备]及其不同贮存时间(1~5周)(条形码)、输血前后48 h血红蛋白值(Hb)等;经统计分析评估血液病和恶性肿瘤患者输注不同贮存期去白悬红的疗效。结果本组输注去白悬红的血液病和恶性肿瘤患者共3557名,各输注不同贮存期去白悬红患者(组)的输血量、性别以及既往输血史的输血有效率均无明显变化(P>0.05);4组患者分别输注贮存1~2周、>2~3周、>3~4周、>4~5周不同单位去白悬红的有效率比较,均为贮存>4~5周去白悬红(组)最低,分别是血液病(组)78.77%、77.68%、75.06%、70.37%和恶性肿瘤(组)79.32%、76.73%、72.79%、67.65%(P<0.05)。结论本中心供应临床的绝大部分去白悬红的贮存时间≥3周,有待对更多输注贮存5周去白悬红病例的输注效果做更长时间的观察;采供血机构有必要应用循证医学方法与信息化管理手段,处理好临床用血效期、缩短红细胞从贮存到输注的流转时间,以确保和提高输血疗效。

Objective To investigate the effect of leukocyte-depleted suspended red blood cells(lds-RBCs)storaged for different time on blood transfusion effect of patients with hematologic diseases and malignant tumors,as well as to evaluate the storage quality of lds-RBCs in blood stations.Methods Seven hospitals(4 tertiary-A hospitals and 3 secondary-A hospitals),applying for blood from our blood center,were selected.Blood transfusion cases(medical record)and related data(indicators)of patients with blood diseases and malignant tumors in those hospitals from December 2018 to May 2019 were collected,including disease diagnosis(type)before transfusion,demographic characteristics,date of solo transfusion of lds-RBCs,units of lds-RBCs[(1~2)U/bag,1 U=200 mL whole blood],different storage duration(1~5 weeks)(bar code),and hemoglobin(Hb)48 h before and after transfusion.The efficacy of lds-RBCs(storaged for different time)transfusion in patients with hematologic diseases and malignant tumors was evaluated by statistical analysis.Results A total of 3557 patients with hematologic diseases and malignant tumors were enrolled in this study.No significant changes were noticed in transfusion efficacy by blood transfusion unit,gender and previous transfusion history(P>0.05).The effective rate of lds-RBCs in patients with blood diseases and malignant tumors,stratified by storage duration,i.e.storaged for>1~2 weeks,>2~3 weeks,>3~4 weeks and more than>4~5 weeks,was 78.77%vs 77.68%vs 75.06%vs 70.37%,and 79.32%vs 76.73%vs 72.79%vs 67.65%,respectively(P<0.05),with lds-RBCs of 4-5 storage weeks presenting the lowest transfusion efficacy in both groups of patients.Conclusion The storage time of most lds-RBCs supplied by our center is moren than 3 weeks,and the transfusion effect of lds-RBCs stored for 5 weeks needs further observation.In order to ensure and improve the efficacy of blood transfusion,evidence-based medicine and information management are needed to help the clinical gasp the advantageous time of blood products and shorten the storage-to-transfusion time of red blood cells.